What matters in the patients' decision to revisit the same primary care physician?

To assess the priority of various aspects of the patient-primary care physician relationship in the decision to visit again that same physician. A total of 400 community residents in Ras Beirut, Lebanon. Study design: A cross-sectional community based study sampled by a nonrandom sex-education quota-based procedure. Participants were asked to fill a survey where they indicated the ranking of nine items by importance in their decision to revisit the same physician. The nine items were chosen from three categories of factors: professional expertise of the physician ; characteristics of the patient-physician relationship, office organization. Having a physician that gives the patient adequate time for discussion prevailed as rank 1 and luxurious clinic ranked as 9th. Affordability was one of the main concerns among men, those with poor health and those of lower socioeconomic status. Accessibility of the physician's phone was considered highly important among women and those of lesser education status. This study emphasizes the importance of adequate time with the patient, accessibility and affordability of the physician in maintaining continuity of care and patient satisfaction, beyond mere medical expertise

Common dermatologic diseases among students at a tertiary care center in Lebanon

There are few publications on prevalence of skin diseases in Lebanon. To find the prevalence of dermatologic diseases among students seen at the university health services of the American University of Beirut. Medical charts were retrospectively reviewed. Chi-square tests were used to assess any significant difference between male and female prevalence amongst all types of skin diseases met; p-value < 0.05 was considered significant. 2903 visits were reviewed, ages ranged from 16 to 33 years old, of whom 1688 were females [58.15%] and 1215 were males [41.85%]. Acne vulgaris was the most prevalent, followed by hair problems and contact dermatitis. Acne vulgaris and hair problems were significantly higher among females, and verruca among males [p < 0.001 in all]. Dermatologists must be aware of the psychological effects of skin diseases on their patients. Acne, hair problems, and contact dermatitis are the most common diseases seen. Patients seem to be more concerned about diseases that affect their image in society

List of essential drugs for primary care in Lebanon

In 1966, Lebanon had around 19,000 drug formulations registered in the Ministry of Public Health. The government decreased that number to 5400 in 1992 through numerous interventions. In 1995 and in an effort to rationalize drug prescribing, the Lebanese government organized an ad hoc committee of medical and pharmaceutical experts to review the 1992 list and create a list of essential drugs for primary care [LEDPC]. This report describes the process and the studies used to update the 1992 list by the ad hoc committee

Cancer screening for the primary care physician

Cancer screening guidelines are developed by numerous agencies. These guidelines are often conflicting leaving the primary care physician in a difficult position. He [she] is requested to choose the best test for his or her patients taking into consideration the principles of screening, the test cost and most importantly the patient's emotional and physical well-being. Screening for some cancers, like lung cancer, has been considered of no benefit. Other cancers, like breast, colon, cervix and prostate, have been the subject of numerous recommendations: For breast cancer, clinical examination and mammography are recommended every 1-2 years for women between 50 to 70 years. For cervical cancer, PAP smear is suggested every 1-3 years and for colorectal cancer, a yearly fecal occult blood, sigmoidoscopy or colonoscopy every 5-10 years. Annual serum prostate specific antigen [PSA] and digital rectal examination screening for prostate cancer are still controversial

Recommendations for the school health physical examination in Lebanon

School health developed gradually over the years; starting with efforts to keep contagion out of school to global programs of comprehensive services. One of its components, school medicine, covers screening examinations, record maintenance, emergency care, immunization monitoring and health counseling. This paper proposes the essential health activities to be performed during a screening school examination in Lebanon. The recommendations are based on a combination of international literature review of evidence and the existence of Lebanese epidemiological reports identifying specific problems. Vaccination record review, tuberculin testing, vision, hearing, dental and skin disorders screening procedures are proposed as essential activities of the school physical examination

Most common diseases treated in primary health care facilities in Lebanon

The Lebanese Ministry of Health has requested public health experts to assess the most common health problems seen in Primary Health Care [PHC] facilities. This paper presents the results of this assessment conducted in a convenience sample of PHC centers. The assessment aimed at identifying areas of strength and gaps in the current system. Data were drawn from 23 PHC centers in various regions of Lebanon, in addition to an 8-year review of the experience of the Department of Family Medicine at the American University Hospital. In general, 46% of all visits to PHC centers did not include any kind of diagnosis. Most centers provided data on large categories of diseases without breakdown into specific entities. The most commonly identified health problems were hypertension, diabetes and asthma, in addition to eye and ear diseases, cardiologic conditions, and dermatologic problems. Other health problems included ill-defined signs and symptoms associated most likely with mental distress. Dental caries, skin and hair parasites, and respiratory tract infections topped the health problems among children. A qualitative synopsis of all data is presented. The paper highlights the limitations of the current health information system in Lebanon, and suggests corrective measures. It also presents a number of recommendations regarding the optimal use of PHC centers for health education and promotion and for disease prevention